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Revishvili A.Sh.

Vishnevsky National Medical Research Center of Surgery of the Ministry of Health of Russia

Olovyanniy V.E.

Vishnevsky National Medical Research Center of Surgery of the Ministry of Health of Russia

Markov P.V.

Vishnevsky National Medical Research Center of Surgery

Gurmikov B.N.

Vishnevsky National Medical Research Center of Surgery

Trifonov S.A.

Vishnevsky Center of Surgery

Bile duct injuries following cholecystectomy: current situation in the Russian Federation

Authors:

Revishvili A.Sh., Olovyanniy V.E., Markov P.V., Gurmikov B.N., Trifonov S.A.

More about the authors

Journal: Pirogov Russian Journal of Surgery. 2026;(1): 6‑13

DOI: 10.17116/hirurgia20260116

Read: 1575 times

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Table of contents

BILE DUCT INJURIES FOLLOWING CHOLECYSTECTOMY: CURRENT SITUATION IN THE RUSSIAN FEDERATION
BILE DUCT INJURIES FOLLOWING CHOLECYSTECTOMY: CURRENT SITUATION IN THE RUSSIAN FEDERATION

To cite this article:

Revishvili ASh, Olovyanniy VE, Markov PV, Gurmikov BN, Trifonov SA. Bile duct injuries following cholecystectomy: current situation in the Russian Federation. Pirogov Russian Journal of Surgery. 2026;(1):6‑13. (In Russ.)
https://doi.org/10.17116/hirurgia20260116

Подписка 2026 Хирургия. Журнал им. Н.И. Пирогова (Pirogov Russian Journal of Surgery)
МСФ на ЯМ
Использование инфографики авторами научных работ
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Abstract:

OBJECTIVE. T

O assess the current situation regarding iatrogenic bile duct injuries (BDI) in the Russian Federation.

MATERIAL AND METHODS

A retrospective analysis enrolled cases of BDI that required reconstructive surgery in 2023. Data were collected through online survey of medical institutions registered in annual reporting database of the Chief Surgeon of the Russian Ministry of Health, where BDIs were documented.

RESULTS

There were 227 BDIs. Data from 126 (59.0%) patients were obtained via online survey. Laparoscopic cholecystectomy (LC) was performed in 107 (84.9%) cases. Acute cholecystitis was indication in 77 (61.1%) cases. BDI occurred in 25 (19.8%) cases at the first level hospitals, 69 (54.8%) cases — at the second level, 32 (25.4%) cases — at the third level facilities. Intraoperative diagnosis of BDI was established in 62 (49.2%) cases. According to the Strasberg classification, type D injuries accounted for 32 cases, type E — 94 cases. Roux-en-Y hepaticojejunostomy was performed in 72 (57.1%) cases, bilio-biliary anastomosis over a T-tube — 20 (15.9%), bile duct repair over a stent — 8 (6.3%), primary bile duct suture without stent — 9 (7.1%), hemihepatectomy — 1 (0.8%), external biliary drainage — 12 (9.5%), other procedures — 4 (3.2%). Surgical approach and outcomes depended on timing of BDI diagnosis and type of intervention. Complications were observed in 20 (15.9%) cases, including hepaticojejunal anastomotic failure in 10/72 patients (13.9%). Overall mortality rate was 4.8%. The reported leading cause of BDI (83.3% of respondents) was difficult bile duct identification due to fibrotic-inflammatory changes in subhepatic space.

CONCLUSION

The main cause of BDI during cholecystectomy is fibrotic-inflammatory changes in subhepatic space. Compliance with principles of safe cholecystectomy is of paramount importance. BDI requires referral to a specialized center. Timely diagnosis of BDI improves the outcomes.

Keywords:

cholecystectomy
bile duct injury
reconstructive bile duct surgery

Authors:

Revishvili A.Sh.

Vishnevsky National Medical Research Center of Surgery of the Ministry of Health of Russia

Olovyanniy V.E.

Vishnevsky National Medical Research Center of Surgery of the Ministry of Health of Russia

Markov P.V.

Vishnevsky National Medical Research Center of Surgery

Gurmikov B.N.

Vishnevsky National Medical Research Center of Surgery

Trifonov S.A.

Vishnevsky Center of Surgery

Received:

20.05.2025

Accepted:

15.06.2025

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